Pregnancy Loss

This is a really challenging post for me to write, since I have not shared much about my pregnancy loss with people. I'll start by admitting I dislike the term "miscarriage." I want to use this venue not to share the details of my pregnancy loss, but rather to explore the way my personal feelings and my social context collided. It seemed to me like American language and social norms did a poor job making meaning of what I experienced emotionally and physically.

As I started to write this post, being the nerd that I am, I did some research on the etymology of the term miscarriage, which was actually very cathartic for me. I found several interesting articles on the subject (see references at the end of the post, if interested). While I don't necessarily agree with the views of the articles' authors, I found them really insightful for giving me a historical perspective on the value-laden language surrounding what I experienced, and why American society seems to do such a poor job with accommodating women's reactions to pregnancy loss.

Why do I dislike the word miscarriage? For one, the word itself implied it was just my body's failure to carry the baby. In her analysis, Jutel (2006, p. 427) puts it this way: "Miscarriage implies the failure of the mother/womb to protect the dependent fetus, while stillbirth conveys the autonomy of existence and the innocence of the mother in the infant death." So when I would use the word miscarriage to describe my loss, I had a very negative emotional response to it as the word came out of my mouth. By my medical caregivers, I was urged to think of the loss as a sad blessing. My midwife encouraged me to come in for an ultrasound after the bleeding began to be sure that what I was experiencing was a miscarriage. I looked at the ultrasound footage, as my midwife explained that what she saw was just some small remaining pieces of tissue. I do not recall her exact words, but while she was very nurturing, she essentially said that a miscarriage was "nature's way" of ending a pregnancy that was not healthy. Nature's way. Survival of the fittest. So I should count myself blessed that this baby didn't go to term - something was wrong with him or her. Indeed, to watch one's child suffer and lose that child is the most horrifying, unfair loss imaginable to me. I have seen people lose their children, and pregnancy loss is not the same. Yet, it still seemed to me that the use of the words "miscarriage" and "nature's way" were inadequate for what I felt as a real loss. What I felt emotionally was joy turned to sorrow, and grief for dreams of a child that were now just shadows.

I also resented that my loss was a political issue. Reagan's (2003) article does a nice job of detailing how miscarriage has been co-opted by multiple political movements in the United States throughout the 20th century. I didn't realize that some might conclude I'm making a political statement of my own by preferring the term "pregnancy loss" to "miscarriage." Reagan argues that the movement to use the term pregnancy loss rather than miscarriage draws on both the pro-life and feminist movements to comprehend and define miscarriage, female emotion, and motherhood. According to her historical analysis, only since the 1980s have women have been encouraged to speak more openly about their grief following miscarriage, which she attributes to the success of the women's health and pregnancy loss movements. Reagan's article is fascinating in its exploration of the political history behind how miscarriage is understood, but she lost me was when she interprets the offering of grief ceremonies to mothers who have experienced pregnancy loss as anti-feminist, and "requiring that she grieve and join the political project of making the fetus into a person." (p. 368) I personally feel offended by the idea that to want to grieve my loss meant that I was making any political statement, or that I am anti-feminist if I thought of the fetus inside of me as a person.

Photo by jpellegen

Jutel (2006) notes that not all cultures use viability or gestational age in their assessment of personhood. She points out that the Maori culture uses the same word for fetus, baby, and child. Another culture that I'm familiar with is Japanese culture, having lived there for four years and studied the language for much of my adult life. There are temple rituals and services to memorialize pregnancy loss (mizuko kuyo), whether due to miscarriage, stillbirth or abortion. Many temples regularly hold mizuko services where women and men can come to worship. According to interviews with women who attend mizuko services, their emotional and spiritual reasons for attending range from sin atonement to ancestral respect. While women each have their own personal reasons for practicing mizuko kuyo, its very existence in Japanese society provides a cultural space for those who have experienced any kind of pregnancy loss to grieve and be comforted. Feminist critiques have taken a normatively negative view of mizuko kuyo, seeing the temples as exploiting women's guilt and grief. According to that perspective, the entire temple culture in Japan should be seen as exploitive, as worshippers pay for blessings on or atonement for a variety of life experiences, ranging from passing exams to pregnancy loss. According to my spiritual worldview, "Blessed are those who mourn, for they will be comforted" (Matthew 5: 4). In other words, it's hard to receive comfort if one does not mourn. While I don't believe I personally can pay a price for atonement or blessing, I really wish we had something like mizuko kuyo in American culture - a non-politicized space to mourn and receive comfort. Some good friends who knew about our pregnancy and its loss brought us flowers and a meal as soon as they heard and visited with us. That meant so much to me, and I think that's because flowers and visitation represent something in our society. They represent an attempt to comfort someone who is grieving.

Part of the reason we have no cultural space for grieving a miscarriage is political, but part of it is a social custom that has existed despite the ebb and flow of social movements around women's rights and reproduction. That is the custom of silence about pregnancy until the first trimester (at least) is over. We don't share in case "something happens." Regardless of the fact that Reagan's analysis of media representations finds women are speaking out more about "miscarriage" since the 1980s, the norm of silence has not broken. Most women still do stay silent about it, or share in private with only their closest confidants. I myself followed this custom, and only shared our pregnancies early on with parents and a handful of friends. But that custom of silence during early pregnancy implies an expectation of silence if "something happens." I know I felt (whether it's true or not) that because of the norm of silence, people didn't want to hear about it. I didn't even want to take too much time off of work - despite the fact that I was enduring a very painful physical experience on top of my emotional pain - in case people thought something was "really wrong." I took a couple of sick days, and when I went in still suffering, some of my coworkers kindly asked me if I was feeling better. I forget what I said... I tried not to be dishonest, while also still not sharing. I think something like I was "taking it easy." And I tried not to burst into spontaneous tears for the next couple of weeks at the office. The whole custom of silence makes women's experiences of pregnancy loss largely anonymous.

Jutel ultimately concludes that women should have the agency to choose the language that best explains the meaning they make of their pregnancy loss experiences. "Bringing the discussion back to the woman allows her the opportunity to acknowledge 'losing the baby,' if this is how she interprets the experience." (p. 433) Given the contested nature of American language surrounding what is growing inside a woman's pregnant body - fetus, baby, child - and what happens when a healthy child is not the result of a pregnancy - miscarriage, stillbirth, abortion - I feel like I can't even choose the language I'd like to explain my experience and subsequent grief. The custom of silence and lack of language and cultural norms for mourning made me feel like I was forced to choke down my grief. Like being amommymous, it's an empty feeling. But a woman who has suffered pregnancy loss isn't amommymous. She can't even claim to be a "mommy," since - according to our culture - she never had a "child."

What I can say is that while Jeff and I did grieve mostly alone, I could always turn to God for comfort. I believe God loves me, and that though this was "nature's way," it wasn't His way. (A good book on my theology of suffering is "Is God to Blame?".) I often sought time alone for myself to cry and listen to a song with the following refrain:

"This is what it means to be held,
how it feels when the sacred is torn from your life
and you survive.

This is what it is to be loved and to know
that the promise was that when everything fell
we'd be held." (from Held by Natalie Grant)

References

Jutel, A. 2006. "What's in a Name? death before birth." Perspectives in Biology and Medicine, 49(3): 425-34.

Regean, L.J. 2003. "From Hazard to Blessing to Tragedy: Representations of miscarriage in twentieth-century America. Feminist Studies: FS, 29(2): 356-78.